Lin Jie, Weng Xiongpeng, Zheng Jing, Wu Saizhen, Bao Qiongqiong, Peng Feifei, Huang Yanbin
Department of Neurology, Yueqing People's Hospital, Wenzhou, China.
Department of Neurology, Affiliated Huangyan Hospital of Wenzhou Medical University, Taizhou First People's Hospital, Taizhou, China.
Front Neurol. 2023 Dec 18;14:1281412. doi: 10.3389/fneur.2023.1281412. eCollection 2023.
Cerebral cavernous malformation (CCM) is a rare disease associated with a latent risk of intracranial hemorrhage. However, due to limited evidence, the safety of recommending intravenous tissue plasminogen activators for patients with acute stroke and CCM remains uncertain.
Our study identified five patients with acute stroke and CCM treated between 2017 and 2023 across two hospitals. A comprehensive literature review was conducted, incorporating three similar case reports and two retrospective studies.
Among 30 patients reviewed, three exhibited symptomatic intracranial hemorrhage, two of whom were women. Additionally, three patients presented with calcification in their CCM, with two experiencing symptomatic intracranial hemorrhage.
The observed incidence of symptomatic intracranial hemorrhage following intravenous tissue plasminogen activator administration appears to be elevated in patients with CCM. Therefore, before thrombolysis, a thorough evaluation of personalized risk-benefit ratios is crucial. Furthermore, conducting further research involving multiple centers and larger sample sizes is imperative to advance our understanding in this area, especially in identifying hemorrhage risk factors.
脑海绵状血管畸形（CCM）是一种罕见疾病，存在颅内出血的潜在风险。然而，由于证据有限，对于急性卒中合并CCM的患者推荐静脉注射组织型纤溶酶原激活剂的安全性仍不确定。
我们的研究纳入了2017年至2023年间在两家医院接受治疗的5例急性卒中和CCM患者。进行了全面的文献综述，纳入了3篇类似病例报告和2项回顾性研究。
在纳入综述的30例患者中，3例出现有症状性颅内出血，其中2例为女性。此外，3例患者的CCM存在钙化，其中2例出现有症状性颅内出血。
CCM患者静脉注射组织型纤溶酶原激活剂后有症状性颅内出血的发生率似乎有所升高。因此，在溶栓前，全面评估个性化的风险效益比至关重要。此外，开展涉及多个中心和更大样本量的进一步研究对于增进我们在该领域的理解必不可少，尤其是在识别出血危险因素方面。
